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Individual

DR. SEAN PATRICK CONNOLLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1585 THIRD STREET, USA DENTAC, FT POLK, LA 71446
(337) 531-4762
(337) 531-6506
Mailing address
1585 THIRD STREET, USA DENTAC, FT POLK, LA 71446
(337) 531-4762
(337) 531-6506

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DEN-10015
CO
1223P0300X
Periodontics
Primary
10015
CO

Other

Enumeration date
08/20/2009
Last updated
06/13/2013
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